MRI诊断前置胎盘伴胎盘植入的临床价值及影像学特征分析  

Analysis on the Clinical Value and Imaging Features of MRI in the Diagnosis of Placenta Previa Complicated with Placenta Accreta

作　　者：梅琪 王雷[1] MEI Qi;WANG Lei(Imaging Department,Bengbu Third People's Hospital,Bengbu 233000,China)

机构地区：[1]安徽省蚌埠市第三人民医院影像科,安徽蚌埠233000

出　　处：《临床医学工程》2025年第3期333-336,共4页Clinical Medicine & Engineering

基　　金：蚌埠医科大学自然科学重点科技项目(项目编号:2023byzd120)。

摘　　要：目的分析磁共振成像(MRI)对前置胎盘伴胎盘植入的诊断价值及影像学特征。方法收集2021年6月至2024年10月我院收治的80例前置胎盘患者的临床资料及MRI检查资料,根据是否合并胎盘植入分为胎盘植入组和无胎盘植入组。观察MRI对前置胎盘伴胎盘植入的诊断价值,比较MRI不同序列对前置胎盘伴胎盘植入的诊断效能,分析两组的MRI影像学特征。结果经术后病理证实,80例前置胎盘患者伴胎盘植入54例,无胎盘植入26例。胎盘植入组的剖宫产≥2次及人工流产史占比均高于无胎盘植入组(P<0.05)。MRI诊断前置胎盘伴胎盘植入的准确率为93.75%,与术后病理一致性较好(Kappa值为0.873,P<0.001)。T2WI联合DWI序列诊断前置胎盘伴胎盘植入的灵敏度、准确度均高于T2WI、DWI单一序列(P<0.05)。胎盘植入组的T2WI序列胎盘内低信号带、子宫肌层低信号连续性中断、膀胱形态改变或子宫局部膨隆占比均高于无胎盘植入组(P<0.05)。结论MRI诊断前置胎盘伴胎盘植入与病理结果一致性较好,且多序列联合诊断的效能高于单一序列;T2WI序列胎盘内低信号带、子宫肌层低信号连续性中断、膀胱形态改变或子宫局部膨隆是MRI诊断前置胎盘伴胎盘植入的主要影像学特征。Objective To analyze the clinical value and imaging features of magnetic resonance imaging(MRI)in the diagnosis of placenta previa complicated with placenta accreta.Methods The clinical data and MRI examination data of 80 patients with placenta previa admitted to our hospital from June 2021 to October 2024 were collected.All cases were divided into the placenta accreta group and non-placenta accreta group according to the presence of placenta accreta.The diagnostic value of MRI for placenta previa complicated with placenta accreta was observed,the diagnostic efficacy of different MRI sequences for placenta previa complicated with placenta accreta was compared,and the MRI imaging features of the two groups were compared.Results Postoperative pathology confirmed that among 80 patients with placenta previa,54 cases were complicated with placenta accreta and 26 cases were without placenta accreta.The proportions of≥2 cesarean sections and history of induced abortion in the placenta accreta group were higher than those of the non-placenta accreta group(P<0.05).The accuracy of MRI in the diagnosis of placenta previa complicated with placenta accreta was 93.75%,and the consistency with postoperative pathology was good(Kappa value=0.873,P<0.001).The sensitivity and accuracy of T2WI combined with DWI sequence in diagnosing placenta previa complicated with placenta accreta were higher than those of single sequence of T2WI and DWI(P<0.05).The proportions of low signal bands in the placenta of T2WI sequence,interruption of low signal continuity in uterine muscle layer,and changes in bladder morphology or local dilation of the uterus in the placenta accreta group were higher than those of the non-placenta accreta group(P<0.05).Conclusions MRI shows good consistency with pathological results in the diagnosis of placenta previa complicated with placenta accreta,and the efficacy of combined multi-sequence diagnosis is higher than that of single sequence.Low signal bands in the placenta of T2WI sequence,interruption of low sign

关 键 词：磁共振成像 前置胎盘 胎盘植入 诊断价值 影像学特征 

分 类 号：R445.2[医药卫生—影像医学与核医学]